Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

pharm exam 2 > Topic 7 Antihypertensive > Flashcards

Topic 7 Antihypertensive Flashcards

1
Q

“Staged” HTN:

Pre-HTN (mmHg)

A

120-130/80-90 mm Hg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

“Staged” HTN

Stage 1 HTN (mmHg)

A

140-160/90-100 mm Hg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

“Staged” HTN

Stage 2 HTN (mmHg)

A

> 160/100 mm Hg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Hypertension pressures?

A

Sustained systolic BP > 140 (120)mmHg or a sustained diastolic BP > 90 mm Hg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Primary (Essential)

A

HTN is caused by a blend of nurture and nature, is generally idiopathic (what’s this?) and is the most common form (~90%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Secondary HTN

A

caused by a specific etiology and is less common (~10%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

BP =

A

CO x SVR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

most antihypertensives work to alter

blood pressure by what two things

A

1)Decreasing cardiac output
or
2)Decreasing peripheral resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

CO and SVR are generally controlled by what two things?

A

1) The SNS and baroreceptotor feedback.
and/or
2) The Renin/Angiotensin System

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Frequently HTN is treated with what type of therapy ?

A

“combination therapy”

more than one category of drug therapy is used to treat HTN to minimize side-effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

In critters with “stiff” arteries, having 110%

of normal blood volume can cause

A

profound HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

In critters with “stiff” arteries having 95% of normal blood volume can mean

A

the critter’s normotensive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

First line of defense against HTN

A

Diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Why are Diuretics the first line of defense against HTN?

A

fairly safe (wide therapeutic margin) and inexpensive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Recent evidence indicates diuretics are

superior for treatment of HTN in what population?

A

In the elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Second line of defense against HTN

A

β-Blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

β-Blockers decrease what?

A

Decrease C.O.
Decrease SNS “tone”
Decrease renal renin release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Nadolol

A

Nonselective β-Blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Atenolol and Lorpressor, Toprol-XL are what type of drug?

A

Beta 1 Selective Blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

“Bystolic” is what type of drug?

A

β₁-selective and a potent vasodilator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

β-Blockers are best on what demographic

A

Evidence suggests these are best in young &

white patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

β-Blockers are NOT best with what demographic?

A

NOT well suited for patients with CHF, asthma,
&/or COPD. Black patients respond relatively
poorly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Third line of defense against HTN

A

ACE-Inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

“ACE” = stands for what?

A

“Angiotensin Converting Enzyme”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

ACE-Inhibitors prevent what conversion?

A

Prevents pulmonary and renal endothelium

from converting Angiotensin I into Angiotensin II (the active form)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Commonly used as a first line drug post-MI for HTN

A

ACE Inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Can be used in patients with systolic dysfunction to treat HTN

A

ACE Inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Biggest use-limiting side-effect of ACE Inhibitors

A

dry cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Captopril

A

Capoten

ACE Inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Enalapril

A

Vasotec

ACE Inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Lisinopril

A

Prinivil, Zestril

ACE Inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Benazepril

A

Lotensin

ACE Inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Fosinopril

A

Monopril

ACE Inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Moexipril

A

Univasc

ACE Inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Quinapril

A

Accupril

ACE Inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Ramipril

A

Altace

ACE Inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Trandolapril

A

Mavik

ACE Inhibitor

38
Q

DON’T cause bradykinin release and fewer respiratory side-effects (particularly coughing)

A

Angiotensin II-Receptor Blockers (“ARBs”)

39
Q

Losartan

A

Cozaar

ARB

40
Q

Valsartan

A

Diovan

ARB

41
Q

Candesartan

A

Atacand

ARB

42
Q

Eprosartan

A

Teveten

ARB

43
Q

Irbesartan

A

Avapro

ARB

44
Q

Telmisartan

A

Micardis

ARB

45
Q

Olmesartan

A

Benicar

ARB

46
Q

Aliskiren

A

Tekturna

Renin Inhibitor

47
Q

Capoten

A

Captopril

ACE Inhibitor

48
Q

Vasotec

A

Enalapril

ACE Inhibitor

49
Q

Mavik

A

Trandolapril

ACE Inhibitor

50
Q

Altace

A

Ramipril

ACE Inhibitor

51
Q

Accupril

A

Quinapril

ACE Inhibitor

52
Q

Univasc

A

Moexipril

ACE Inhibitor

53
Q

Monopril

A

Fosinopril

ACE Inhibitor

54
Q

Lotensin

A

Benazepril

ACE Inhibitor

55
Q

Prinivil, Zestril

A

Lisinopril

ACE Inhibitor

56
Q
  • Act by decreasing the outflow of sympathetic firing from the CNS.
  • Decreased peripheral vascular tone
  • Used in combination therapies
A

α₂-Agonists or Centrally Acting Sympathoplegics

57
Q

α₂-Agonists major side effect

A

All tend to cause sedation as a major side-effect

58
Q

Clonidine

A

Catapres, Duraclon

α₂-Agonist

59
Q

Clonidine useful in what patients? why?

A

Dilates peripheral vessels but not renal arteries

Useful in HTN complicated by renal disease

60
Q

α-Methyldopa

A

Aldomet

α₂-Agonist

61
Q

α-Methyldopa has less what?

A

less trans-placental passage

62
Q

blocking α₁ SNS stimulation causes what?

A

smooth muscles to relax……resulting in both venous and arterial dilation

63
Q

Prazosin

A

Minipres

α₁-Blockers

64
Q

Doxazosin

A

Cardura

α₁-Blockers

65
Q

Terazosin

A

Hytrin

α₁-Blockers

66
Q

Hydralazine

A

Apresoline

67
Q

Hydralazine (Apresoline) how does it work?

A

Causes endothelial cells to release nitric oxide—a potent vasodilator causing smooth muscle relaxation

68
Q

Hydralazine (Apresoline) greatest effect

A

Arterial & arteriole effect&raquo_space;venous effect

69
Q

Hydralazine (Apresoline) does what to SVR and BP?

A

SVR falls.

Arterial pressure drops

70
Q

Hydralazine (Apresoline) typical adult dose

A

Typical adult bolus: 2.5-5.0mg q15 minutes (maximum20-40mg

71
Q

Hydralazine (Apresoline) dose for severe acute HTN

A

Typical dose for severe acute HTN (including pregnancy-induced): 10-20 mg slow IV

72
Q

Nitroglycerin does what at lower doses?

A

At lower doses venous dilation>arterial

73
Q

Nitroglycerin does what at higher doses?

A

At higher doses arterial dilation>venous

74
Q

Used for treatment of angina for > 100 year

A

Nitroglycerin

75
Q

How does Nitroglycerin work?

A

Converted to nitric oxide by mitochondrial

enzymes

76
Q

Nitroglycerin decreases what ? (4)

A

Decreases B.P., pulmonary capillary wedge
pressure, and SVR.
Decrease myocardial O2 demand during ischemia while leaving contractility unaffected

77
Q

pts with “coronary spasms” or “air down

the coronaries” use what often ?

A

Nitroglycerin

78
Q

How to administer Nitroglycerin on bypass?

A

Dosing on bypass typically via bolus or IV

infusion to affect, tends to be site specific

79
Q

Nitroglycerin Typical adult dose

A

Typical adult dose:–50-100μg bolus–0.1-7.0μ g/kg/minute

80
Q

Nitroglycerin Typical pediatric infusion

A

Typical pediatric infusion:–0.1-0.5μg/kg/minute

81
Q

Nitroprusside

A

“Nipride” or “Nitropress”

82
Q

Nitroprusside (Nipride or Nitropress)

A

Potent arterial & capacitance dilator.
…so it decreases both preload and afterload
which helps increase C.O. in patients
with heart failure

83
Q

Nitroprusside (Nipride or Nitropress) MUST be given how?

A

parenterally

84
Q

Nitroprusside (Nipride or Nitropress) used to control what on CPB?

A

Very commonly used to control BP on CPB

both bolus and IV drip

85
Q

Nitroprusside (Nipride or Nitropress) breaks down into what 2 things?

A

Breaks down in the blood stream into nitric

oxide and cyanide

86
Q

Nitroprusside (Nipride or Nitropress) T1/2?

A

1-2 minutes

87
Q

Nitroprusside (Nipride or Nitropress) toxic metabolite ?

A

toxic metabolite thiocyanate has a half-life of many days

88
Q

Nitroprusside (Nipride or Nitropress) normal adult dosage?

A

Normal adult dosage is 0.5-10.0 μg/kg/min (peds receive the low end of this dose)

89
Q

Nitroprusside (Nipride or Nitropress) can cause toxicity when?

A

DO NOT give at higher dosages for more than ten minutes or toxicity can result

90
Q

Cyanide “shuts down” what?

A

cellular metabolism

91
Q

Nitroprusside & NTG are often used at what point of bypass

A

at CPB termination

pharm exam 2 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions